It may soon be possible to predict which children receiving surgery are most likely to need strong post-operative pain relief.

Senthilkumar Sadhasivam, MD, MPH, an anesthesiology researcher at Cincinnati Children’s, analyzed data from 149 children who had recently received tonsillectomies. He found that patients carrying certain variations of the catechol-O-methyltransferase (COMT) gene were up to three times more likely than other patients to require morphine to control their pain after surgery.

Details about the single nucleotide polymorphisms (SNPs) that appear to affect pain perception appear in the study, “Genetics of pain perception, COMT and postoperative pain management in children,” published in February in Pharmacogenomics. The journal’s editors designated the study its “Research Article of the Month.”

“This study represents a welcomed start toward applying genotyping for improved surgical pain management in children," says David Gurwitz, senior editor of the journal.

The research team is adding more children to the study from Cincinnati Children’s and 15 other pediatric hospitals. Their goal is to further validate the initial findings and identify additional important genes in surgical pain management.

In the years ahead, genetic testing will likely become a routine part of surgical practice, Sadhasivam predicts.

“The cost of genetic testing is trending down,” Sadhasivam says. “Though there will be some additional costs to genetic testing compared to current practice, we anticipate bigger downstream benefits in terms of timely and adequate management of pain, avoidance of adverse effects from strong pain medications and delayed discharge following surgery.”